title: Does improved access and greater choice of nicotine replacement therapy affect smoking cessation success? Findings from a randomized controlled trial.
abstract: OBJECTIVE
  To determine the effect of offering smokers who want to quit easy access to nicotine replacement therapy (NRT), a period of familiarization and choice of product on smoking abstinence at 6 months.
  
  
  METHODS
  Single-blind, randomized controlled trial.
  
  
  METHODS
  New Zealand.
  
  
  METHODS
  A total of 1410 adult smokers who called the national Quitline for quitting support were randomized to usual Quitline care or a box containing different NRT products (patch, gum, inhaler, sublingual tablet, oral pouch) to try for a week prior to quitting, and then to choose one or two of these products for 8 weeks' use.
  
  
  METHODS
  The primary outcome was 7-day point prevalence smoking abstinence 6 months after quit day. Secondary outcomes included continuous abstinence, cigarette consumption, withdrawal, NRT choice and serious adverse events at 1 and 3 weeks and 3 and 6 months.
  
  
  RESULTS
  No differences in 6-month quit rates (7-day point prevalence or continuous abstinence) were observed between the groups. However, smokers allocated to the intervention group were more likely to have quit smoking at 3 months [self-reported point prevalence, relative risk (RR)=1.17, 95% confidence interval (CI): 1.02, 1.35, P=0.03], had a longer time to relapse (median 70 days versus 28 days, P<0.01) and used significantly more NRT. The selection box concept was highly acceptable to users, with the patch and inhaler combination the most popular choice (34%).
  
  
  CONCLUSIONS
  In terms of smoking abstinence at 6 months, offering smokers who want to quit free access to a wide range of nicotine replacement therapy, including a 1-week period of familiarization and choice of up to two products, appears no different to offering reduced cost and choice of nicotine replacement therapy, with no familiarization period. This trial is registered with the Australasian Clinical Trials Network Number: ACTRN 12606000451505.
authors.affiliation: Clinical Trials Research Unit, School of Population Health, The University of Auckland, Auckland, New Zealand. n.walker@ctru.auckland.ac.nz
authors.forename: Natalie
authors.initials: N
authors.lastname: Walker
authors.forename: Colin
authors.initials: C
authors.lastname: Howe
authors.forename: Chris
authors.initials: C
authors.lastname: Bullen
authors.forename: Michele
authors.initials: M
authors.lastname: Grigg
authors.forename: Marewa
authors.initials: M
authors.lastname: Glover
authors.forename: Hayden
authors.initials: H
authors.lastname: McRobbie
authors.forename: Murray
authors.initials: M
authors.lastname: Laugesen
authors.forename: Joy
authors.initials: J
authors.lastname: Jiang
authors.forename: Mei-Hua
authors.initials: MH
authors.lastname: Chen
authors.forename: Robyn
authors.initials: R
authors.lastname: Whittaker
authors.forename: Anthony
authors.initials: A
authors.lastname: Rodgers
mesh_terms: D000328:Adult; D002755:Choice Behavior; D004333:Drug Administration Routes; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D057194:Intention to Treat Analysis; D053208:Kaplan-Meier Estimate; D008297:Male; D009520:New Zealand; D009538:Nicotine / Q000008:administration & dosage* / Q000191:economics; D018722:Nicotinic Agonists / Q000008:administration & dosage* / Q000191:economics; D057240:Patient Preference; D012008:Recurrence; D012907:Smoking / Q000188:drug therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D016896:Treatment Outcome
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine